Healthcare Provider Details

I. General information

NPI: 1023944758
Provider Name (Legal Business Name): VEROVITALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 62ND AVE
VERO BEACH FL
32966-6536
US

IV. Provider business mailing address

4045 62ND AVE
VERO BEACH FL
32966-6536
US

V. Phone/Fax

Practice location:
  • Phone: 772-563-7490
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARIA V MALLIA
Title or Position: OWNER
Credential: APRN
Phone: 772-563-7490